Capsulitis of the Foot
Capsulitis of the foot, also called MTP (metatarsophalangeal) synovitis, causes a sharp or aching pain in the ball of the foot, often centered beneath the base of the second toe. Increased pressure on the metatarsophalangeal joint can contribute to the development of capsulitis. This pain indicates a separation of the proximal phalanx, the bone at the base of the toe, and the metatarsal, the long bone of the foot.
What Is Capsulitis of the Toe Joint in the Foot?
When the joints located at the base of the toes experience a significant amount of pressure and stress, inflammation beneath the ball of the foot often occurs. This condition is called capsulitis of the foot, and it affects the toe bones that assist with bending, stretching, and other movements. Because your toes support balance and movement, capsulitis can cause serious limitations in mobility when left untreated.
Developing capsulitis can be influenced by certain risk factors, such as foot structure, activity level, and prolonged immobilization. As capsulitis progresses, it can cause deformity of the affected toe and may lead to dorsal dislocation. While capsulitis most commonly occurs in the second toe, it may also affect the third and fourth toes.
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What Causes Capsulitis of the Foot and Risk Factors
Capsulitis of the foot is caused by increased stress on the metatarsophalangeal joint at the base of the toe, which leads to inflammation and degeneration of the ligaments and tissues that hold the joint together.
Increased stress is often caused by activities that generate excessive load on the ball of the foot, such as climbing ladders, squatting, or using an elliptical trainer or stair machine. High-heeled shoes, rheumatoid arthritis, and structural issues like a bunion, high arch, or long second toe can also contribute. Systemic conditions such as thyroid disease can increase the risk of developing capsulitis, similar to their role in conditions like frozen shoulder. Capsulitis of the foot most commonly occurs in individuals between ages 30 and 60.
How Does Capsulitis of the Foot Develop?
Capsulitis of the foot, often referred to as toe capsulitis, develops when the joint capsule surrounding the toe joint—most commonly the second toe—becomes inflamed due to excess pressure. This pressure may result from high-heeled shoes, abnormal toe structure, or faulty foot mechanics that place stress on the ball of the foot. Over time, the strain causes soft tissue around the joint to become irritated and swollen, leading to pain and discomfort.
If capsulitis is left untreated, the inflammation can worsen, eventually weakening the ligaments that stabilize the toe joint. This can result in the second toe drifting toward the big toe, a deformity known as crossover toe. In advanced cases, the joint may dislocate, requiring surgical intervention to restore alignment and relieve pain. Recognizing early signs and addressing underlying causes is essential to prevent these complications.
Capsulitis of the Foot Symptoms
Capsulitis is a painful condition that can significantly impact daily activities. Patients often experience burning or aching pain in the ball of the foot that worsens when walking without shoes on hard surfaces. As symptoms progress, the toes may shift position, causing increased pain and difficulty walking.
How Is Capsulitis of the Foot Diagnosed?
At Resurgens Orthopaedics, an expert physician will evaluate your symptoms by reviewing your medical history and performing a physical exam to assess your foot. Light pressure may be applied to the affected area to evaluate pain and swelling. Imaging tests such as X-rays or MRIs may be used to rule out other conditions and evaluate the soft tissues and joints in detail.
Comparison to Other Conditions
Capsulitis of the foot shares similarities with other painful joint and soft tissue conditions, but it’s important to distinguish the differences. For example, Morton’s neuroma causes foot pain due to nerve compression, while capsulitis results from inflammation and irritation of the joint capsule at the base of the toe.
A similar inflammatory process can occur in the shoulder with a condition known as adhesive capsulitis (frozen shoulder). Both involve inflammation and thickening of the joint capsule that leads to pain and restricted movement, though they affect different parts of the body.
Capsulitis of the Second Toe
Capsulitis most often affects the second toe, making it a common cause of pain in the ball of the foot. The joint capsule of the second toe is particularly vulnerable to excess pressure caused by footwear, structural abnormalities, or repetitive stress. If left untreated, capsulitis can lead to crossover toe, where the second toe drifts over the big toe. Early intervention with physical therapy, custom orthotics, and proper footwear can help relieve pressure, reduce pain, and prevent deformity.
Capsulitis of the Foot Treatment
Nonsurgical treatment is typically the first approach for capsulitis. Rest, ice, and proper footwear can help restore normal function if addressed early. In some cases, corticosteroid injections may be used to reduce inflammation and pain. Early intervention improves outcomes and reduces the likelihood of surgical treatment.
In advanced cases, surgery may be needed to remove scar tissue, restore joint function, or repair ligaments. For comparison, a similar procedure called capsular release may be performed for adhesive capsulitis of the shoulder, though this is a different condition.
Foot Care for Capsulitis Patients
Foot care is essential for managing capsulitis and preventing recurrence. Wear supportive shoes that cushion the ball of the foot and have a wide toe box. Avoid high-heeled shoes, which increase forefoot pressure. Custom orthotics may be recommended for additional support. Stretching and physical therapy can help maintain flexibility and strength in the foot, improving recovery and function.
Living With Capsulitis of the Foot
Managing capsulitis requires active participation in your care. Understanding the causes, symptoms, and treatment options helps you make informed health decisions. Left untreated, capsulitis can become a chronic source of pain or lead to deformity.
Complications and Prevention
When untreated, capsulitis can lead to complications such as crossover toe, hammer toes, or chronic pain. To prevent these issues, early treatment is essential. Physical therapy strengthens and stretches the muscles around the affected joint, while supportive shoes and orthotics help distribute weight more evenly.
Early intervention, as seen with other conditions like frozen shoulder, can significantly improve outcomes.
Recovery and Outlook
The outlook for capsulitis of the foot is positive, especially with early treatment. Most people recover within 6 weeks to 3 months with rest, orthotics, and physical therapy. Untreated cases or those with deformities may require surgery. Working closely with a healthcare provider ensures effective treatment and long-term relief. Early diagnosis and commitment to care are key to recovery and lasting foot health.
If you’re experiencing pain or stiffness in the ball of your foot, schedule an appointment with a Resurgens Foot & Ankle Center specialist today. Our experts can help you find relief and get back on your feet.